The Diagnostic and Statistical Manual of Mental Disorders is currently under review by psychiatrists and other mental health professionals for its fifth edition (the DSM-V) before its official printing in 2013. Included in the draft of the DSM-V is a new section on Hoarding Disorder, listing hoarding as its own diagnosis separate from Obsessive-Compulsive Disorder.
The disorder is identified by five characteristics, the first three being:
A. Persistent difficulty discarding or parting with personal possessions, even those of apparently useless or limited value, due to strong urges to save items, distress, and/or indecision associated with discarding.
B. The symptoms result in the accumulation of a large number of possessions that fill up and clutter the active living areas of the home, workplace, or other personal surroundings (e.g., office, vehicle, yard) and prevent normal use of the space. If all living areas are uncluttered, it is only because of others’ efforts (e.g., family members, authorities) to keep these areas free of possessions.
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).
The third point, that the hoarder is incapable of “maintaining a safe environment for self and others,” seems to be the dividing line between hoarding and chronic disorganization.
Hoarding also appears in multiple places in the document as a symptom of other disorders. According to the Hoarding Disorder entry in the DSM-V draft, hoarding can also be a symptom of Obsessive-Compulsive Disorder, Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autistic Disorder, and food storing in the Prader-Willi Syndrome.
I’m interested in following this topic to see if the proposed Hoarding Disorder ends up as a separate diagnosis in the final version of the DSM-V. Hoarding has appeared in previous versions of the DSM, but only as a symptom of other disorders. If it does make the final version, I hope that it helps people who are hoarders to get the quality treatment they need.